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  • 1. Almon, Ricardo
    et al.
    Alvarez-Leon, Eva E
    Engfeldt, Peter
    Serra-Majem, Lluís
    Magnuson, Anders
    Nilsson, Torbjörn K
    Department of Clinical Chemistry, Örebro University Hospital.
    Associations between lactase persistence and the metabolic syndrome in a cross-sectional study in the Canary Islands2010In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 49, no 3, p. 141-146Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The single nucleotide polymorphism (SNP) LCT -13910 C>T, associated with genetically determined phenotypes of lactase persistence (LP) or non-persistence (LNP), was studied in relation to the metabolic syndrome (MS).

    AIM OF THE STUDY: The aim was to determine if milk intake and MS are associated. We applied Mendelian randomization (MR). The SNP, LCT -13910 C>T, with the genotypes LP (TT/CT) and LNP (CC), was taken as a proxy for milk consumption.

    METHODS: A representative sample of adults belonging to the Canary Islands Nutrition Survey (ENCA) in Spain aged 18-75 years (n = 551) was genotyped for the LCT -13910 C>T polymorphism. We used the International Diabetes Federation (IDF) criteria to define MS.

    RESULTS: 60% of the population was LP and 40% LNP. One hundred seven LP subjects (35.0%) and 53 LNP subjects (25.6%) showed MS (chi (2) = 5.04, p = 0.025). LP subjects showed a significantly higher odds ratio (OR) for MS than LNP subjects computed for the whole population: both the crude OR (1.56; 95% CI 1.06-2.31) and adjusted OR for sex, age, daily energy intake, physical activity and educational level (1.57; 95% CI 1.02-2.43). Adjusted OR for women with LP was 1.93; 95% CI 1.06-3.52.

    CONCLUSIONS: The T allele of the SNP might constitute a nutrigenetic factor increasing the susceptibility of LP subjects, especially women, to develop MS in the Canary Islands.

  • 2. Arouca, Aline B.
    et al.
    Santaliestra-Pasías, Alba M.
    Moreno, Luis A.
    Marcos, Ascensión
    Widhalm, Kurt
    Molnár, Dénes
    Manios, Yannis
    Gottrand, Frederic
    Kafatos, Anthony
    Kersting, Mathilde
    Sjöström, Michael
    Sáinz, Ángel Gutiérrez
    Ferrari, Marika
    Huybrechts, Inge
    González-Gross, Marcela
    Forsner, Maria
    Umeå University, Faculty of Medicine, Department of Nursing. School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    De Henauw, Stefaan
    Michels, Nathalie
    Diet as a moderator in the association of sedentary behaviors with inflammatory biomarkers among adolescents in the HELENA study2019In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 58, no 5, p. 2051-2065Article in journal (Refereed)
    Abstract [en]

    AIM: To assess if a healthy diet might attenuate the positive sedentary-inflammation relation, whereas an unhealthy diet may increase the effect of sedentary behaviors on inflammatory biomarkers.

    METHODS: In 618 adolescents (13-17 years) of the European HELENA study, data were available on body composition, a set of inflammation markers, and food intake assessed by a self-administered computerized 24 h dietary recall for 2 days. A 9-point Mediterranean diet score and an antioxidant-rich diet z-score were used as dietary indices and tested as moderators. A set of low-grade inflammatory characteristics was used as outcome: several cytokines in an inflammatory ratio (IL-6, IL-10, TNF-α, TGFβ-1), C-reactive protein, three cell-adhesion molecules (sVCAM-1, sICAM-1, sE-selectin), three cardiovascular risk markers (GGT, ALT, homocysteine) and three immune cell types (white blood cells, lymphocytes, CD3). Sedentary behaviors were self-reported and analyzed as total screen time. Multiple linear regression analyses tested moderation by diet in the sedentary behaviors-inflammation association adjusted for age, sex, country, adiposity (sum of six skinfolds), parental education, and socio-economic status.

    RESULTS: Both diet scores, Mediterranean and antioxidant-rich diet, were significant protective moderators in the effect of sedentary behaviors on alanine-transaminase enzyme (P = 0.014; P = 0.027), and on the pro/anti-inflammatory cytokine ratio (P = 0.001; P = 0.004), but not on other inflammatory parameters.

    CONCLUSION: A higher adherence to the Mediterranean diet or an antioxidant-rich diet may attenuate the onset of oxidative stress signs associated by sedentary behaviors, whereas a poor diet seems to increase inflammation.

  • 3.
    Blomquist, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Chorell, Elin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Ryberg, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Mellberg, Caroline
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Worrsjö, Evelina
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Physiological chemistry.
    Makoveichuk, Elena
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Physiological chemistry.
    Larsson, Christel
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Olivecrona, Gunilla
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Physiological chemistry.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Decreased lipogenesis-promoting factors in adipose tissue in postmenopausal women with overweight on a Paleolithic-type diet2018In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 57, no 8, p. 2877-2886Article in journal (Refereed)
    Abstract [en]

    Purpose: We studied effects of diet-induced postmenopausal weight loss on gene expression and activity of proteins involved in lipogenesis and lipolysis in adipose tissue.

    Methods: Fifty-eight postmenopausal women with overweight (BMI 32.5 ± 5.5) were randomized to eat an ad libitum Paleolithic-type diet (PD) aiming for a high intake of protein and unsaturated fatty acids or a prudent control diet (CD) for 24 months. Anthropometry, plasma adipokines, gene expression of proteins involved in fat metabolism in subcutaneous adipose tissue (SAT) and lipoprotein lipase (LPL) activity and mass in SAT were measured at baseline and after 6 months. LPL mass and activity were also measured after 24 months.

    Results: The PD led to improved insulin sensitivity (P < 0.01) and decreased circulating triglycerides (P < 0.001), lipogenesis-related factors, including LPL mRNA (P < 0.05), mass (P < 0.01), and activity (P < 0.001); as well as gene expressions of CD36 (P < 0.05), fatty acid synthase, FAS (P < 0.001) and diglyceride acyltransferase 2, DGAT2 (P < 0.001). The LPL activity (P < 0.05) and gene expression of DGAT2 (P < 0.05) and FAS (P < 0.05) were significantly lowered in the PD group versus the CD group at 6 months and the LPL activity (P < 0.05) remained significantly lowered in the PD group compared to the CD group at 24 months.

    Conclusions: Compared to the CD, the PD led to a more pronounced reduction of lipogenesis-promoting factors in SAT among postmenopausal women with overweight. This could have mediated the favorable metabolic effects of the PD on triglyceride levels and insulin sensitivity.

  • 4. Dhonukshe-Rutten, Rosalie A M
    et al.
    van Dusseldorp, Marijke
    Schneede, Jörn
    Umeå University, Faculty of Medicine, Medical Biosciences, Clinical chemistry.
    de Groot, Lisette C P G M
    van Staveren, Wija A
    Low bone mineral density and bone mineral content are associated with low cobalamin status in adolescents.2005In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 44, no 6, p. 341-347Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Cobalamin deficiency is prevalent in vegetarians and has been associated with increased risk of osteoporosis. AIM OF THE STUDY: To examine the association between cobalamin status and bone mineral density in adolescents formerly fed a macrobiotic diet and in their counterparts. METHODS: In this cross-sectional study bone mineral density (BMD) and bone mineral content (BMC) were determined by DEXA in 73 adolescents (9-15 y) who were fed a macrobiotic diet up to the age of 6 years followed by a lacto-(-ovo-) vegetarian or omnivorous diet. Data from 94 adolescents having consumed an omnivorous diet throughout their lives were used as controls. Serum concentrations of cobalamin, methylmalonic acid (MMA) and homocysteine were measured and calcium intake was assessed by questionnaire. Analysis of covariance (MANCOVA) was performed to calculate adjusted means for vitamin B12 and MMA for low and normal BMC and BMD groups. RESULTS: Serum cobalamin concentrations were significantly lower (geometric mean (GM) 246 pmol/L vs. 469 pmol/L) and MMA concentrations were significantly higher (GM 0.27 micromol/L vs. 0.16 micromol/L) in the formerly macrobiotic-fed adolescents compared to their counterparts. In the total study population, after adjusting for height, weight, bone area, percent lean body mass, age, puberty and calcium intake, serum MMA was significantly higher in subjects with a low BMD (p = 0.0003) than in subjects with a normal BMD. Vitamin B12 was significantly lower in the group with low BMD (p = 0.0035) or BMC (p = 0.0038) than in the group with normal BMD or BMC. When analyses were restricted to the group of formerly macrobiotic-fed adolescents, MMA concentration remained higher in the low BMD group compared to the normal BMD group. CONCLUSIONS: In adolescents, signs of an impaired cobalamin status, as judged by elevated concentrations of methylmalonic acid, were associated with low BMD. This was especially true in adolescents fed a macrobiotic diet during the first years of life, where cobalamin deficiency was more prominent.

  • 5. Ferrari, Pietro
    et al.
    Freisling, Heinz
    Duell, Eric J
    Kaaks, Rudolf
    Lujan-Barroso, Leila
    Clavel-Chapelon, Françoise
    Boutron-Ruault, Marie-Christine
    Nailler, Laura
    Polidoro, Silvia
    Mattiello, Amalia
    Palli, Domenico
    Tumino, Rosario
    Grioni, Sara
    Knüppel, Sven
    Tjønneland, Anne
    Olsen, Anja
    Overvad, Kim
    Orfanos, Philippos
    Katsoulis, Michail
    Trichopoulou, Antonia
    Quirós, Jose Ramón
    Ardanaz, Eva
    Huerta, José María
    Etxezarreta, Pilar Amiano
    Sánchez, María José
    Crowe, Francesca
    Khaw, Kay-Tee
    Wareham, Nicholas J
    Ocke, Marga
    Bueno-de-Mesquita, Bas
    Peeters, Petra H M
    Ericson, Ulrika
    Wirfält, Elisabet
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Engeset, Dagrun
    Nicolas, Geneviève
    Gallo, Valentina
    Norat, Teresa
    Riboli, Elio
    Slimani, Nadia
    Challenges in estimating the validity of dietary acrylamide measurements2013In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 52, no 5, p. 1503-1512Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Acrylamide is a chemical compound present in tobacco smoke and food, classified as a probable human carcinogen and a known human neurotoxin. Acrylamide is formed in foods, typically carbohydrate-rich and protein-poor plant foods, during high-temperature cooking or other thermal processing. The objectives of this study were to compare dietary estimates of acrylamide from questionnaires (DQ) and 24-h recalls (R) with levels of acrylamide adduct (AA) in haemoglobin.

    METHODS: In the European Prospective Investigation into Cancer and Nutrition (EPIC) study, acrylamide exposure was assessed in 510 participants from 9 European countries, randomly selected and stratified by age, sex, with equal numbers of never and current smokers. After adjusting for country, alcohol intake, smoking status, number of cigarettes and energy intake, correlation coefficients between various acrylamide measurements were computed, both at the individual and at the aggregate (centre) level.

    RESULTS: Individual level correlation coefficient between DQ and R measurements (r DQ,R) was 0.17, while r DQ,AA and r R,AA were 0.08 and 0.06, respectively. In never smokers, r DQ,R, r DQ,AA and r R,AA were 0.19, 0.09 and 0.02, respectively. The correlation coefficients between means of DQ, R and AA measurements at the centre level were larger (r > 0.4).

    CONCLUSIONS: These findings suggest that estimates of total acrylamide intake based on self-reported diet correlate weakly with biomarker AA Hb levels. Possible explanations are the lack of AA levels to capture dietary acrylamide due to individual differences in the absorption and metabolism of acrylamide, and/or measurement errors in acrylamide from self-reported dietary assessments, thus limiting the possibility to validate acrylamide DQ measurements.

  • 6. Freisling, Heinz
    et al.
    Moskal, Aurelie
    Ferrari, Pietro
    Nicolas, Genevieve
    Knaze, Viktoria
    Clavel-Chapelon, Francoise
    Boutron-Ruault, Marie-Christine
    Nailler, Laura
    Teucher, Birgit
    Grote, Verena A.
    Boeing, Heiner
    Clemens, Matthias
    Tjonneland, Anne
    Olsen, Anja
    Overvad, Kim
    Ramon Quiros, J.
    Duell, Eric J.
    Sanchez, Maria-Jose
    Amiano, Pilar
    Chirlaque, Maria-Dolores
    Barricarte, Aurelio
    Khaw, Kay-Tee
    Wareham, Nicholas J.
    Crowe, Francesca L.
    Gallo, Valentina
    Oikonomou, Eleni
    Naska, Androniki
    Trichopoulou, Antonia
    Palli, Domenico
    Agnoli, Claudia
    Tumino, Rosario
    Polidoro, Silvia
    Mattiello, Amalia
    Bueno-de-Mesquita, H. Bas
    Ocke, Marga C.
    Peeters, Petra H. M.
    Wirfalt, Elisabet
    Ericson, Ulrika
    Bergdahl, Ingvar A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hjartaker, Anette
    Engeset, Dagrun
    Skeie, Guri
    Riboli, Elio
    Slimani, Nadia
    Dietary acrylamide intake of adults in the European Prospective Investigation into Cancer and Nutrition differs greatly according to geographical region2013In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 52, no 4, p. 1369-1380Article in journal (Refereed)
    Abstract [en]

    Methodological differences in assessing dietary acrylamide (AA) often hamper comparisons of intake across populations. Our aim was to describe the mean dietary AA intake in 27 centers of 10 European countries according to selected lifestyle characteristics and its contributing food sources in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. In this cross-sectional analysis, 36 994 men and women, aged 35-74 years completed a single, standardized 24-hour dietary recall using EPIC-Soft. Food consumption data were matched to a harmonized AA database. Intake was computed by gender and center, and across categories of habitual alcohol consumption, smoking status, physical activity, education, and body mass index (BMI). Adjustment was made for participants' age, height, weight, and energy intake using linear regression models. Adjusted mean AA intake across centers ranged from 13 to 47 mu g/day in men and from 12 to 39 mu g/day in women; intakes were higher in northern European centers. In most centers, intake in women was significantly higher among alcohol drinkers compared with abstainers. There were no associations between AA intake and physical activity, BMI, or education. At least 50 % of AA intake across centers came from two food groups "bread, crisp bread, rusks" and "coffee." The third main contributing food group was "potatoes". Dietary AA intake differs greatly among European adults residing in different geographical regions. This observed heterogeneity in AA intake deserves consideration in the design and interpretation of population-based studies of dietary AA intake and health outcomes.

  • 7. Freisling, Heinz
    et al.
    Pisa, Pedro T
    Ferrari, Pietro
    Byrnes, Graham
    Moskal, Aurelie
    Dahm, Christina C
    Vergnaud, Anne-Claire
    Boutron-Ruault, Marie-Christine
    Fagherazzi, Guy
    Cadeau, Claire
    Kühn, Tilman
    Neamat-Allah, Jasmine
    Buijsse, Brian
    Boeing, Heiner
    Halkjær, Jytte
    Tjonneland, Anne
    Hansen, Camilla P
    Quirós, J Ramón
    Travier, Noémie
    Molina-Montes, Esther
    Amiano, Pilar
    Huerta, José M
    Barricarte, Aurelio
    Khaw, Kay-Tee
    Wareham, Nicholas
    Key, Tim J
    Romaguera, Dora
    Lu, Yunxia
    Lassale, Camille M
    Naska, Androniki
    Orfanos, Philippos
    Trichopoulou, Antonia
    Masala, Giovanna
    Pala, Valeria
    Berrino, Franco
    Tumino, Rosario
    Ricceri, Fulvio
    de Magistris, Maria Santucci
    Bueno-de-Mesquita, H Bas
    Ocké, Marga C
    Sonestedt, Emily
    Ericson, Ulrika
    Johansson, Mattias
    Umeå University, Faculty of Medicine, Department of Biobank Research. International Agency for Research on Cancer (IARC-WHO), Lyon, France.
    Skeie, Guri
    Weiderpass, Elisabete
    Braaten, Tonje
    Peeters, Petra H M
    Slimani, Nadia
    Main nutrient patterns are associated with prospective weight change in adults from 10 European countries2016In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 55, no 6, p. 2093-2104Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Various food patterns have been associated with weight change in adults, but it is unknown which combinations of nutrients may account for such observations. We investigated associations between main nutrient patterns and prospective weight change in adults.

    METHODS: This study includes 235,880 participants, 25-70 years old, recruited between 1992 and 2000 in 10 European countries. Intakes of 23 nutrients were estimated from country-specific validated dietary questionnaires using the harmonized EPIC Nutrient DataBase. Four nutrient patterns, explaining 67 % of the total variance of nutrient intakes, were previously identified from principal component analysis. Body weight was measured at recruitment and self-reported 5 years later. The relationship between nutrient patterns and annual weight change was examined separately for men and women using linear mixed models with random effect according to center controlling for confounders.

    RESULTS: Mean weight gain was 460 g/year (SD 950) and 420 g/year (SD 940) for men and women, respectively. The annual differences in weight gain per one SD increase in the pattern scores were as follows: principal component (PC) 1, characterized by nutrients from plant food sources, was inversely associated with weight gain in men (-22 g/year; 95 % CI -33 to -10) and women (-18 g/year; 95 % CI -26 to -11). In contrast, PC4, characterized by protein, vitamin B2, phosphorus, and calcium, was associated with a weight gain of +41 g/year (95 % CI +2 to +80) and +88 g/year (95 % CI +36 to +140) in men and women, respectively. Associations with PC2, a pattern driven by many micro-nutrients, and with PC3, a pattern driven by vitamin D, were less consistent and/or non-significant.

    CONCLUSIONS: We identified two main nutrient patterns that are associated with moderate but significant long-term differences in weight gain in adults.

  • 8.
    Karlsson Videhult, Frida
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Öhlund, Inger
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    West, Christina E
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Probiotics during weaning: a follow-up study on effects on body composition and metabolic markers at school age2015In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 54, no 3, p. 355-363Article in journal (Refereed)
    Abstract [en]

    PURPOSE: An aberrant gut microbiome has been suggested to contribute to the worldwide epidemic of obesity. In animal models, the probiotic Lactobacillus paracasei ssp. paracasei F19 (LF19) induced upregulation of genes involved in energy homoeostasis, reduced body fat and altered the serum (S) lipoprotein profile. In our previous report, feeding LF19 to infants during weaning impacted the global plasma metabolome. LF19 lowered palmitoleic acid, a monounsaturated fatty acid associated with hypertriglyceridemia and increased visceral adiposity. Therefore, we assessed if feeding LF19 from 4 to 13 months of age would have long-term effects on body composition, growth and metabolic markers.

    METHODS: Of 179 children included in our baseline study, 120 entered the follow-up at 8-9 years of age, n = 58 in the probiotic and n = 62 in the placebo group. Body composition was measured using dual energy X-ray absorptiometry. Anthropometrics of the child and accompanying parent(s) were assessed. S-lipids, insulin, glucose and transaminases were determined after overnight fasting.

    RESULTS: LF19 did not affect body mass index z-score, sagittal abdominal diameter, fat-free mass, fat mass index, truncal fat %, android or gynoid fat % and had no long-term impact on any of the assessed metabolic markers (p > 0.05).

    CONCLUSION: Feeding LF19 during infancy did not modulate body composition, growth or any of the assessed metabolic markers at school age. The steady increase in probiotic products targeting infants and children calls for long-term follow-up of initiated probiotic intervention studies.

  • 9. Michels, Nathalie
    et al.
    Vynckier, Lisa
    Moreno, Luis A
    Beghin, Laurent
    de la O, Alex
    Forsner, Maria
    Umeå University, Faculty of Medicine, Department of Nursing. Högskolan Dalarna.
    Gonzalez-Gross, Marcela
    Huybrechts, Inge
    Iguacel, Isabel
    Kafatos, Antonio
    Kersting, Mathilde
    Leclercq, Catherine
    Manios, Yannis
    Marcos, Ascension
    Molnar, Denes
    Sjöström, Michael
    Widhalm, Kurt
    De Henauw, Stefaan
    Mediation of psychosocial determinants in the relation between socio-economic status and adolescents' diet quality.2018In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 57, no 3, p. 951-963Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To examine the underlying reasons for the positive relation between socio-economic status (SES) and the diet quality of adolescents.

    METHODS: In 2081 adolescents (12.5-17.5 years) of the European HELENA study, a continuous variable on diet quality via 2-day 24-h recalls was available. SES was reflected by parental education, parental occupation and family affluence. Mediation by several psychosocial determinants was tested: self-efficacy, availability at school and home, social support, barriers, benefits, awareness and some self-reported influencers (parents, school, taste, health, friends, food readily available, easy preparation, hunger, price and habits). Multiple mediation analyses were adjusted for age, sex and country.

    RESULTS: The availability of soft drinks and fruit at home, social support, parental influence, barriers, price influence, taste influence, health influence and food being readily available were significant mediators. The multiple mediation indirect effect accounted for 23-64% of the total effect. Both occupation and education and both maternal and paternal factors could be explained by the mediation. The unavailability of soft drinks was the strongest mediator (17-44% of the total effect).

    CONCLUSION: Up to 64% of the positive relation between SES and the diet quality in adolescence could be explained by several healthy eating determinants. Focusing on these factors in low-SES populations can minimize social inequalities in diet and health by improving the diet of these specific adolescents.

  • 10. Obón-Santacana, Mireia
    et al.
    Lujan-Barroso, Leila
    Freisling, Heinz
    Cadeau, Claire
    Fagherazzi, Guy
    Boutron-Ruault, Marie-Christine
    Kaaks, Rudolf
    Fortner, Renée T
    Boeing, Heiner
    Ramón Quirós, J
    Molina-Montes, Esther
    Chamosa, Saioa
    Castaño, José María Huerta
    Ardanaz, Eva
    Khaw, Kay-Tee
    Wareham, Nick
    Key, Tim
    Trichopoulou, Antonia
    Lagiou, Pagona
    Naska, Androniki
    Palli, Domenico
    Grioni, Sara
    Tumino, Rosario
    Vineis, Paolo
    De Magistris, Maria Santucci
    Bueno-de-Mesquita, H B
    Peeters, Petra H
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Bergdahl, Ingvar A
    Umeå University, Faculty of Medicine, Department of Biobank Research.
    Vesper, Hubert
    Riboli, Elio
    Duell, Eric J
    Dietary and lifestyle determinants of acrylamide and glycidamide hemoglobin adducts in non-smoking postmenopausal women from the EPIC cohort2017In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 56, no 3, p. 1157-1168Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Acrylamide was classified as 'probably carcinogenic' to humans in 1994 by the International Agency for Research on Cancer. In 2002, public health concern increased when acrylamide was identified in starchy, plant-based foods, processed at high temperatures. The purpose of this study was to identify which food groups and lifestyle variables were determinants of hemoglobin adduct concentrations of acrylamide (HbAA) and glycidamide (HbGA) in 801 non-smoking postmenopausal women from eight countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

    METHODS: Biomarkers of internal exposure were measured in red blood cells (collected at baseline) by high-performance liquid chromatography/tandem mass spectrometry (HPLC/MS/MS) . In this cross-sectional analysis, four dependent variables were evaluated: HbAA, HbGA, sum of total adducts (HbAA + HbGA), and their ratio (HbGA/HbAA). Simple and multiple regression analyses were used to identify determinants of the four outcome variables. All dependent variables (except HbGA/HbAA) and all independent variables were log-transformed (log2) to improve normality. Median (25th-75th percentile) HbAA and HbGA adduct levels were 41.3 (32.8-53.1) pmol/g Hb and 34.2 (25.4-46.9) pmol/g Hb, respectively.

    RESULTS: The main food group determinants of HbAA, HbGA, and HbAA + HbGA were biscuits, crackers, and dry cakes. Alcohol intake and body mass index were identified as the principal determinants of HbGA/HbAA. The total percent variation in HbAA, HbGA, HbAA + HbGA, and HbGA/HbAA explained in this study was 30, 26, 29, and 13 %, respectively.

    CONCLUSIONS: Dietary and lifestyle factors explain a moderate proportion of acrylamide adduct variation in non-smoking postmenopausal women from the EPIC cohort.

  • 11. Park, Min Kyung
    et al.
    Freisling, Heinz
    Huseinovic, Ena
    Winkvist, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg.
    Huybrechts, Inge
    Crispim, Sandra Patricia
    de Vries, Jeanne H. M.
    Geelen, Anouk
    Niekerk, Maryse
    van Rossum, Caroline
    Slimani, Nadia
    Comparison of meal patterns across five European countries using standardized 24-h recall (GloboDiet) data from the EFCOVAL project2018In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 57, no 3, p. 1045-1057Article in journal (Refereed)
    Abstract [en]

    Purpose: To examine meal patterns in terms of frequency and circadian timing of eating in five European countries participating in the EFCOVAL project.

    Methods: In this cross-sectional study, 559 men and women, aged 44-65 years, were recruited in Belgium, the Czech Republic, France (Southern part), The Netherlands, and Norway. Dietary data were collected by trained interviewers using standardized computerised 24-h recalls (GloboDiet). Means +/- SE of (1) eating frequency, (2) overnight fasting, and (3) time between eating occasions were estimated by country using means from 2 days of 24-h recalls. We also estimated the frequency of eating occasions per hour by country as well as the proportional energy intake of meals/snacks by country compared to the mean energy intake of all countries.

    Results: Mean eating frequency ranged from 4.3 times/day in France to 7.1 times/day in The Netherlands (p < 0.05). Mean overnight fasting was shortest in the Netherlands (9.2 h) and longest in Czech Republic (10.9 h) (p < 0.05). Mean time between single eating occasions was shortest in The Netherlands (2.4 h) and longest in France (4.3 h) (p < 0.05). Different patterns of energy intake by meals and snacks throughout the day were observed across the five countries.

    Conclusions: We observed distinct differences in meal patterns across the five European countries included in the current study in terms of frequency and circadian timing of eating, and the proportion of energy intake from eating occasions.

  • 12. Solans, Marta
    et al.
    Benavente, Yolanda
    Saez, Marc
    Agudo, Antonio
    Jakszyn, Paula
    Naudin, Sabine
    Hosnijeh, Fatemeh Saberi
    Gunter, Marc
    Huybrechts, Inge
    Ferrari, Pietro
    Besson, Caroline
    Mahamat-Saleh, Yahya
    Boutron-Ruault, Marie-Christine
    Kühn, Tilman
    Kaaks, Rudolf
    Boeing, Heiner
    Lasheras, Cristina
    Sánchez, Maria-Jose
    Amiano, Pilar
    Chirlaque, María Dolores
    Ardanaz, Eva
    Schmidt, Julie A
    Vineis, Paolo
    Riboli, Elio
    Trichopoulou, Antonia
    Karakatsani, Anna
    Valanou, Elisavet
    Masala, Giovanna
    Agnoli, Claudia
    Tumino, Rosario
    Sacerdote, Carlotta
    Mattiello, Amalia
    Skeie, Guri
    Weiderpass, Elisabete
    Jerkeman, Mats
    Dias, Joana Alves
    Späth, Florentin
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Dahm, Christina C
    Overvad, Kim
    Petersen, Kristina Elin Nielsen
    Tjønneland, Anne
    de Sanjose, Silvia
    Vermeulen, Roel
    Nieters, Alexandra
    Casabonne, Delphine
    Inflammatory potential of diet and risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition.2019In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215Article in journal (Refereed)
    Abstract [en]

    Introduction: Chronic inflammation plays a critical role in lymphomagenesis and several dietary factors seem to be involved its regulation. The aim of the current study was to assess the association between the inflammatory potential of the diet and the risk of lymphoma and its subtypes in the European Investigation into Cancer and Nutrition (EPIC) study.

    Methods: The analysis included 476,160 subjects with an average follow-up of 13.9 years, during which 3,136 lymphomas (135 Hodgkin lymphoma (HL), 2606 non-Hodgkin lymphoma (NHL) and 395 NOS) were identified. The dietary inflammatory potential was assessed by means of an inflammatory score of the diet (ISD), calculated using 28 dietary components and their corresponding inflammatory weights. The association between the ISD and lymphoma risk was estimated by hazard ratios (HR) and 95% confidence intervals (CI) calculated by multivariable Cox regression models adjusted for potential confounders.

    Results: The ISD was not associated with overall lymphoma risk. Among lymphoma subtypes, a positive association between the ISD and mature B-cell NHL (HR for a 1-SD increase: 1.07 (95% CI 1.01; 1.14), p trend = 0.03) was observed. No statistically significant association was found among other subtypes. However, albeit with smaller number of cases, a suggestive association was observed for HL (HR for a 1-SD increase = 1.22 (95% CI 0.94; 1.57), p trend 0.13).

    Conclusions: Our findings suggested that a high ISD score, reflecting a pro-inflammatory diet, was modestly positively associated with the risk of B-cell lymphoma subtypes. Further large prospective studies on low-grade inflammation induced by diet are warranted to confirm these findings.

  • 13. Stepien, Magdalena
    et al.
    Duarte-Salles, Talita
    Fedirko, Veronika
    Trichopoulou, Antonia
    Lagiou, Pagona
    Bamia, Christina
    Overvad, Kim
    Tjønneland, Anne
    Hansen, Louise
    Boutron-Ruault, Marie-Christine
    Fagherazzi, Guy
    Severi, Gianluca
    Kühn, Tilman
    Kaaks, Rudolf
    Aleksandrova, Krasimira
    Boeing, Heiner
    Klinaki, Eleni
    Palli, Domenico
    Grioni, Sara
    Panico, Salvatore
    Tumino, Rosario
    Naccarati, Alessio
    Bueno-de-Mesquita, H. Bas
    Peeters, Petra H.
    Skeie, Guri
    Weiderpass, Elisabete
    Parr, Christine L.
    Quirós, José Ramón
    Buckland, Genevieve
    Molina-Montes, Esther
    Amiano, Pilar
    Chirlaque, Maria-Dolores
    Ardanaz, Eva
    Sonestedt, Emily
    Ericson, Ulrika
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Arctic Research Centre at Umeå University.
    Khaw, Kay-Tee
    Wareham, Nick
    Bradbury, Kathryn E.
    Ward, Heather A.
    Romieu, Isabelle
    Jenab, Mazda
    Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort2016In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 55, no 1, p. 7-20Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of the study was to assess associations between intake of combined soft drinks (sugar sweetened and artificially sweetened) and fruit and vegetable juices and the risk of hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBC) and biliary tract cancers (GBTC) using data from the European Prospective Investigation into Cancer and Nutrition cohort of 477,206 participants from 10 European countries.

    METHODS: After 11.4 years of follow-up, 191 HCC, 66 IHBC and 236 GBTC cases were identified. Hazard ratios and 95 % confidence intervals (HR; 95 % CI) were estimated with Cox regression models with multivariable adjustment (baseline total energy intake, alcohol consumption and intake pattern, body mass index, physical activity, level of educational attainment and self-reported diabetes status).

    RESULTS: No risk associations were observed for IHBC or GBTC. Combined soft drinks consumption of >6 servings/week was positively associated with HCC risk: HR 1.83; 95 % CI 1.11-3.02, p trend = 0.01 versus non-consumers. In sub-group analyses available for 91 % of the cohort artificially sweetened soft drinks increased HCC risk by 6 % per 1 serving increment (HR 1.06, 95 % CI 1.03-1.09, n cases = 101); for sugar-sweetened soft drinks, this association was null (HR 1.00, 95 % CI 0.95-1.06; n cases = 127, p heterogeneity = 0.07). Juice consumption was not associated with HCC risk, except at very low intakes (<1 serving/week: HR 0.60; 95 % CI 0.38-0.95; p trend = 0.02 vs. non-consumers).

    CONCLUSIONS: Daily intake of combined soft drinks is positively associated with HCC, but a differential association between sugar and artificially sweetened cannot be discounted. This study provides some insight into possible associations of HCC with sugary drinks intake. Further exploration in other settings is required.

  • 14. Wisnuwardani, Ratih Wirapuspita
    et al.
    De Henauw, Stefaan
    Androutsos, Odysseas
    Forsner, Maria
    Umeå University, Faculty of Medicine, Department of Nursing. School of Education, Health and Social Sciences, Dalarna University, Falun, Sweden.
    Gottrand, Frédéric
    Huybrechts, Inge
    Knaze, Viktoria
    Kersting, Mathilde
    Le Donne, Cinzia
    Marcos, Ascensión
    Molnár, Dénes
    Rothwell, Joseph A.
    Scalbert, Augustin
    Sjöström, Michael
    Widhalm, Kurt
    Moreno, Luis A.
    Michels, Nathalie
    Estimated dietary intake of polyphenols in European adolescents: the HELENA study2019In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 58, no 6, p. 2345-2363Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Knowledge about polyphenols intakes and their determinants among adolescents might be helpful for planning targeted prevention strategies at an early age.

    METHODS: In the European multicenter cross-sectional HELENA study of 2006-2007, 2428 subjects (47% boys) had data on dietary intake of polyphenols from 2 non-consecutive 24 h recalls via linking with the Phenol-Explorer database. Differences by sex, age, country, BMI, maternal education, paternal education, family affluence, smoking status, alcohol use, and physical activity were explored by linear regression.

    RESULTS: Median, lower and upper quartiles of polyphenol intakes were 326, 167 and 564 mg/day, respectively. Polyphenol intake was significantly higher in the oldest (16-17.49 years), girls, non-Mediterranean countries, lowest BMI, highest paternal education, and alcohol consumers. Main food contributors were fruit (23%, mainly apple and pear, i.e., 16.3%); chocolate products (19.2%); and fruit and vegetable juices (15.6%). Main polyphenol classes were flavonoids (75-76% of total) and phenolic acids (17-19% of total). The three most consumed polyphenols were proanthocyanidin polymers (> 10 mers), hesperidin, and proanthocyanidin 4-6 oligomers.

    CONCLUSION: The current study provided for the first time numbers on the total polyphenol intake and their main food sources in a heterogeneous group of European adolescents. Major differences with adult populations are the lower polyphenol consumption and the major food sources, such as chocolate and biscuits. The discussed determinants and polyphenol types already point to some important population groups that need to be targeted in future public health initiatives.

  • 15. Wisnuwardani, Ratih Wirapuspita
    et al.
    De Henauw, Stefaan
    Forsner, Maria
    Umeå University, Faculty of Medicine, Department of Nursing. School of Education, Health and Social Sciences, Dalarna University, Falun, Sweden.
    Gottrand, Frédéric
    Huybrechts, Inge
    Knaze, Viktoria
    Kersting, Mathilde
    Le Donne, Cinzia
    Manios, Yannis
    Marcos, Ascensión
    Molnár, Dénes
    Rothwell, Joseph A.
    Scalbert, Augustin
    Sjöström, Michael
    Widhalm, Kurt
    Moreno, Luis A.
    Michels, Nathalie
    Polyphenol intake and metabolic syndrome risk in European adolescents: the HELENA study2019In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215Article in journal (Refereed)
    Abstract [en]

    Purpose: The role of polyphenol intake during adolescence to prevent metabolic syndrome (MetS) is little explored. This study aimed to evaluate the association between intake of total polyphenols, polyphenol classes and the 10 most consumed individual polyphenols with MetS risk in European adolescents.

    Methods: Of the cross-sectional HELENA study, 657 adolescents (54% girls; 14.8% overweight; 12.5–17.5 year) had a fasting blood sample and polyphenol intake data from two non-consecutive 24-h recalls matched with the Phenol-Explorer database. MetS was defined via the pediatric American Heart Association definition. Multilevel linear regressions examined the associations of polyphenol quartiles with MetS components, while logistic regression examined the associations with MetS risk.

    Results: After adjusting for all potential confounders (socio-demographics and nine nutrients), total polyphenol intake, polyphenol classes and individual polyphenols were not associated with MetS risk. From all MetS components, only BMI z-score was modestly inversely associated with total polyphenol intake. Further sub analyses on polyphenol classes revealed that flavonoid intake was significantly associated with higher diastolic blood pressure and lower BMI, and phenolic acid intake was associated with higher low-density cholesterol. For individual polyphenols, the above BMI findings were often confirmed (not independent from dietary intake) and a few associations were found with insulin resistance.

    Conclusion: Higher intakes of total polyphenols and flavonoids were inversely associated with BMI. No consistent associations were found for other MetS components.

  • 16. Zamora-Ros, Raul
    et al.
    Knaze, Viktoria
    Rothwell, Joseph A.
    Hémon, Bertrand
    Moskal, Aurelie
    Overvad, Kim
    Tjønneland, Anne
    Kyrø, Cecilie
    Fagherazzi, Guy
    Boutron-Ruault, Marie-Christine
    Touillaud, Marina
    Katzke, Verena
    Kühn, Tilman
    Boeing, Heiner
    Förster, Jana
    Trichopoulou, Antonia
    Valanou, Elissavet
    Peppa, Eleni
    Palli, Domenico
    Agnoli, Claudia
    Ricceri, Fulvio
    Tumino, Rosario
    de Magistris, Maria Santucci
    Peeters, Petra H. M.
    Bueno-de-Mesquita, H Bas
    Engeset, Dagrun
    Skeie, Guri
    Hjartåker, Anette
    Menéndez, Virginia
    Agudo, Antonio
    Molina-Montes, Esther
    Huerta, José María
    Barricarte, Aurelio
    Amiano, Pilar
    Sonestedt, Emily
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Arctic Research Centre at Umeå University.
    Landberg, Rikard
    Key, Timothy J.
    Khaw, Kay-Thee
    Wareham, Nicholas J.
    Lu, Yunxia
    Slimani, Nadia
    Romieu, Isabelle
    Riboli, Elio
    Scalbert, Augustin
    Dietary polyphenol intake in Europe: the European Prospective Investigation into Cancer and Nutrition (EPIC) study2016In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 55, no 4, p. 1359-1375Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVES: Polyphenols are plant secondary metabolites with a large variability in their chemical structure and dietary occurrence that have been associated with some protective effects against several chronic diseases. To date, limited data exist on intake of polyphenols in populations. The current cross-sectional analysis aimed at estimating dietary intakes of all currently known individual polyphenols and total intake per class and subclass, and to identify their main food sources in the European Prospective Investigation into Cancer and Nutrition cohort.

    METHODS: Dietary data at baseline were collected using a standardized 24-h dietary recall software administered to 36,037 adult subjects. Dietary data were linked with Phenol-Explorer, a database with data on 502 individual polyphenols in 452 foods and data on polyphenol losses due to cooking and food processing.

    RESULTS: Mean total polyphenol intake was the highest in Aarhus-Denmark (1786 mg/day in men and 1626 mg/day in women) and the lowest in Greece (744 mg/day in men and 584 mg/day in women). When dividing the subjects into three regions, the highest intake of total polyphenols was observed in the UK health-conscious group, followed by non-Mediterranean (non-MED) and MED countries. The main polyphenol contributors were phenolic acids (52.5-56.9 %), except in men from MED countries and in the UK health-conscious group where they were flavonoids (49.1-61.7 %). Coffee, tea, and fruits were the most important food sources of total polyphenols. A total of 437 different individual polyphenols were consumed, including 94 consumed at a level >1 mg/day. The most abundant ones were the caffeoylquinic acids and the proanthocyanidin oligomers and polymers.

    CONCLUSION: This study describes the large number of dietary individual polyphenols consumed and the high variability of their intakes between European populations, particularly between MED and non-MED countries.

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